In a nutshell
This study compared three minimally invasive surgical procedures used to treat benign prostatic hyperplasia (BPH). Researchers reported good outcomes with each procedure with some differences in recovery time and prostate size reduction.
Some background
Transurethral resection of the prostate (TURP) is the most common surgery used for treating BPH-related symptoms. It involves the destruction of prostate tissue through a wire loop inserted into the urethra (the penile opening). Removing enlarged tissue from the prostate allows for better flow through the urethra and relieves symptoms of BPH.
More recently developed surgical procedures include GreenLight photoselective vaporization (PVP) and thulium laser vapoenucleation (ThuVEP). Both techniques use high-intensity lasers inserted through the urethra to vaporize enlarged prostate tissue. PVP and ThuVEP have previously been associated with fewer complications and faster recovery time than the standard of care TURP procedure.
Methods & findings
The aim of this study was to directly compare the three surgical procedures: TURP, PVP, and ThuVEP.
The records of 2,648 men with BPH were included in analysis. 798 men were treated with TURP. 468 men received treatment with PVP. 1,382 men were treated with ThuVEP. Patients were followed for an average of 48 months.
Each procedure was associated with immediate improvements in urinary symptoms. This included an increase in urine flow rate and more complete bladder emptying following treatment.
ThuVEP was associated with more efficient prostate tissue removal compared to TURP. Men with very large prostates (80 cubic centimeters or larger) therefore required less operating time with ThuVEP than with TURP.
Hospital stays were significantly shorter following PVP (average 2 days) or ThuVEP (average 3 days) when compared to TURP (average 4 days). Men with very large prostates benefited more from ThuVEP in terms of recovery time than men with smaller prostates.
The rate of side effects was comparable between treatment groups. PVP was associated with the lowest overall rate of side effects (17.3%) compared to ThuVEP (23.2%) and TURP (20.1%). A small group of men (2.5 to 5.5%, depending on procedure) required additional treatment due to bleeding. Overall, 2.4% of men required a blood transfusion during surgery. Urinary incontinence after surgery occurred in 1.5 to 2.1% of men.
The bottom line
Researchers concluded that minimally invasive procedures are safe and effective in treating BPH symptoms. PVP was associated with the lowest rate of complications, while ThuVEP showed an advantage in terms of prostate size reduction compared to TURP.
Published By :
World Journal of Urology
Date :
Jun 04, 2016
